Nursing homes in the pandemic


Like rivets popping on a sinking ship, the stresses of the pandemic are showing the weakness in our societies. Suddenly we realise how much we depend on humble workers who provide essential services, how much we depend on supply chains, how vulnerable the elderly are, and so on. And everyone has become an epidemiologist. 

One statistic that caught my eye was the number of over-65s in care per thousand of population. This came up as part of Donald Trump's boast that the per capita death rate in the United States is far lower than the highest nation, which was Belgium. There's a reason for that -- Belgium is counting many deaths in nursing homes as deaths from coronavirus, even if the people had not been tested. 

But a chart in the BBC story showed that Belgium also has the the third highest proportion of people in nursing homes in Europe, 71 per thousand. Even higher were the Netherlands (75) and Luxembourg (82). Is it a coincidence that these three countries have also legalised euthanasia? What does that figure say about their social structure? After the pandemic has passed, it would be good to follow this up. 

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Wild theories


I'm not sure who was the first to say, "“Never let a good crisis go to waste". But lots of people are taking this wisdom to heart in the Covid-19 pandemic. It's a time when unconventional ideas will get a warmer welcome than usual because of the fear and the sense of urgency in the air. Perhaps that's why organ donation euthanasia sounds a bit more plausible if Covid-19 victims are doing the donating. See the report below.  

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Coronavirus pandemic continues


It takes a strong character not to get a bit dejected at the current situation. If you're not sick, you're probably in isolation. Still worse, you could be in isolation and jobless. You need some cheering up, so my advice is to watch this video about hand-washing from Uganda. The artist is H.E. Bobi Wine, an extraordinary character who is a local pop star and a candidate for president in upcoming elections. 

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More about coronavirus


One of the saddest stories from the coronavirus pandemic comes from Iran. As of Friday, there had been 53,000 cases and 3,300 deaths. But, adding to the country's misery, hundreds of people have died after drinking methanol as a “remedy”. It illustrates the danger of a panicked response to the virus. Most of our other stories revolve around the crisis as well.

We'll be taking a break next week for the Easter holiday. See you later in the month. 

Michael Cook  
Editor, BioEdge 

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The partying is over


My favourite quote about coronavirus does not come from one of the internet's legion of epidemiological experts, but from an American college student on spring break in Miami. “If I get corona, I get corona. At the end of the day, I'm not gonna let it stop me from partying”. After appearing on CBS News, he regrets saying that. Anyhow, we are taking the pandemic seriously at BioEdge, as you can see in our articles below. 

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More about the coronavirus pandemic


One of the guidelines of the UK’s Nuffield Council on Bioethics about the coronavirus pandemic (see below) is that “Liberty-infringing measures to control disease, such as quarantine and isolation, can be justified if the risk of harm to others can be significantly reduced.”

I agree, but I am still surprised at how few questions have been raised about the draconian restrictions on civil liberties prompted by the crisis. These are sure to lead to recession, soaring unemployment, bankruptcies, and social dislocation. They are the harshest that I have ever experienced in my lifetime – and, with few exceptions, there’s been nary a peep of opposition. In fact, my impression is that op-ed pages segued smoothly from anger at government overreach to anger at government underreach in a month.  

How long can lockdowns be sustained? As the Wall Street Journal points out, “no society can safeguard public health for long at the cost of its overall economic health.” I don't think that it is utilitarian to observe that deferring or suppressing discussion of the costs, financial and social, of our response to the coronavirus could backfire. Human dignity is paramount; acting ethically is essential. But good ethics is based on a knowledge of all the facts -- and not just the facts about hand-washing. 

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Coronavirus special


Most of today’s newsletter is devoted to the coronavirus outbreak. Send us some feedback.

Two countries at the epicentre of the outbreak are particularly interesting in their response to the crisis. Taiwan has reported 50 cases and one death. Even though it is so close to China, Korea and Japan, it has the lowest incidence rate per capita in the world at the moment — around 1 in every 500,000 people.

The measures Taiwan has taken have been extraordinarily effective – and apparently ignored by the international community. Why? Because Taiwan is not a member of the World Health Organization. It was forced out by the People’s Republic of China for longstanding historical and political reasons. Now the rest of the world is paying the price for WHO’s weakness.  

As an op-ed in USA Today argues, Taiwan ought to be admitted to the WHO, even it if puts China’s nose out of joint. “Pandemics don’t care about human politics,” says Mia Ping-Chieh Chen.

The other country is North Korea. “The infectious disease did not flow into our country yet,” says a government newspaper. That is an astonishing achievement – no cases, no deaths. It’s better by far than Taiwan.

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Italy goes into coronavirus lockdown


Milan is in the grip of an epidemic. Towns have been quarantined. Public gatherings have been cancelled. The streets are empty. Incompetent public officials are trying to dampen mounting hysteria. Dark rumours are circulating. Hospital wards are overflowing.

The coronavirus?

No, the Great Plague of 1630 in which perhaps a million (1,000,000) people died. About two hundred and fifty (250) have died so far in Italy’s coronavirus outbreak. That figure alone should immunise you against nostalgia for the Good Old Days. The panic and suffering of the citizens of Milan during the bubonic plague -- who also had to cope with a drought, a famine and the Thirty Years’ War -- make coronavirus seem like a Sunday summer picnic.

There’s a dearth of good news about the panic, illness, death and economic disruption of the world’s coronavirus epidemic. The only positive I can think of is that it may send people back to the Great Italian Novel, I Promessi Sposi (The Betrothed), which was published by Alessandro Manzoni in 1827. The climax of its complicated plot is a vivid description of the Great Plague.

If you want to be thankful for dodging a bullet by being born 400 years later than the events he described, dive into Chapters 31, 32 and 33. There are a number of instructive parallels with current events.  

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The right to die spreads to Germany


“Progressive! Individuals have a right to ‘self-determined’ suicide, including the freedom to take one's own life and to enlist support provided by third parties. German court rules assisted suicide ban violates citizens' rights to determine their own death.”

This was tweeted by Philip Nitschke, Australia’s indefatigable campaigner for an unfettered right to die. It was a good summary of a decision by the German Federal Constitutional Court on Wednesday, which declared that banning assisted suicide was against Germany’s ‘Basic Law’.

From now on people will be free to seek commercial assistance to help them die. (At least doctors won’t be co-opted, for the moment.) This opens up all sorts of business opportunities. Will there be death doulas in every funeral home? Watch this space.

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Portugal moves closer to euthanasia


Portugal could be the next country to legalise euthanasia and assisted suicide. A bill is still in committee but it has the support of the government. Read all about it below. 

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